PB2693: ANEMIA IN HEMATOLOGIC MALIGNANCIES: NOT ONLY A SYMPTOM.
Authors: Oumayma Hari, El Mehdi Mahtat, Moussa Bouh Hawa, Othman Doghmi, Selim Jennane, Hicham El Maaroufi, Doghmi Kamal
Journal: HemaSphere (2023)

Topic: 35. Quality of life and palliative care Background: Anemia is the most common symptom in hematology. When associated to hematologic malignancies, it affects remarkably the patient’s life’s quality and their performant status. In multiple myeloma (MM) and chronic lymphocytic leukemia (CLL) anemia at time of diagnosis occurs in over 60% and 10% of patients respectively and is a potential element in initial staging as well as in tracking the progress of the disease. Data about anemia are rare in other hematologic malignancies and its impact is unclear. Aims: Our work mainly aimed to define the prevalence of anemia at time of diagnosis of hematologic malignancies-excluding MM and CLL- and identify its impact on patient’s overall survival (OS). Methods: Our study is retrospective, including all patients followed for hematologic malignancies (except multiple myeloma and chronic lymphocytic leukemia) from June 2006 to August 2022. We considered anemia when hemoglobin was under 12g/dl. Data including epidemiology, laboratory features and evolution were collected and analyzed with SPSS version 20. Quantitative variables were described in term of means, median and standard deviations; quantitative variables were described as absolute percentage of each modality. Kaplein Meier curves was used to calculate overall survival between different subgroups. Cox regression was used to multivariate analysis. The median follow up time was 38 months. Results: 540 cases of hematologic malignancies (MM and CLL excluded) were followed in our unit over 13 years. The sex ratio was 2. The median age was 52 years. About two thirds of patients had chronic lymphoproliferative diseases (69%) and half of all patients had poor prognosis (47%). Independently of renal impairment, the prevalence of anemia at time of diagnosis was 59.7%; 62% of them were male. Anemia was equitably distributed between younger patients (<45 years) and the older category (46-65 years old) with 39% and 37% respectively, less prevalence was noted in patients older than 66 years (26%). The highest prevalence of anemia was seen in patients with chronic lymphoproliferative disease (55%), followed by acute myeloblastic leukemia (13.8%), myelodysplastic syndrome (11%), chronic myeloid leukemia (8%) and acute lymphoblastic leukemia (6%). In univariate and multivariate analyses, we noted a significative impact of anemia at time of diagnosis on OS (p=0.009 and p<0.001 respectively); mean of OS in patients with and without anemia were respectively 171 and 190 months, the medians were not reached in both of groups (Figure1).Figure 1: Overall survival of patients with and without anemia at time of diagnosis of hematologic malignancies. Summary/Conclusion: At diagnosis of hematologic malignancies, the presence of anemia adds substantially to morbidity and negatively affects patients’ overall survival, quality of life and may also impact the response to treatment. Keywords: Survival, Hematological malignancy, Anemia